Evaluation of suture strength of asymmetric six-strands pennington suture in finger flexor tendon suture

For the medical treatment of damage or ruptures in the flexor digital tendon, finger flexor tendon suture surgery is utilized. In previous studies, various core suture methods have indicated that important factors affect biomechanical properties, including the number of suture strands. In many sutur...

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Main Authors: Raita MIYAJI, Chika MIYAMOTO, Takeshi SHIMOTO, Atsushi ISHIKAWA, Hidehiko HIGAKI, Go MIAKE, Naoya KOZONO, Takamitsu OKADA
Format: Article
Language:Japanese
Published: The Japan Society of Mechanical Engineers 2018-02-01
Series:Nihon Kikai Gakkai ronbunshu
Subjects:
Online Access:https://www.jstage.jst.go.jp/article/transjsme/84/859/84_17-00191/_pdf/-char/en
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author Raita MIYAJI
Chika MIYAMOTO
Takeshi SHIMOTO
Atsushi ISHIKAWA
Hidehiko HIGAKI
Go MIAKE
Naoya KOZONO
Takamitsu OKADA
author_facet Raita MIYAJI
Chika MIYAMOTO
Takeshi SHIMOTO
Atsushi ISHIKAWA
Hidehiko HIGAKI
Go MIAKE
Naoya KOZONO
Takamitsu OKADA
author_sort Raita MIYAJI
collection DOAJ
description For the medical treatment of damage or ruptures in the flexor digital tendon, finger flexor tendon suture surgery is utilized. In previous studies, various core suture methods have indicated that important factors affect biomechanical properties, including the number of suture strands. In many suture methods, Fore-strands core suture and Six-strands core suture are used. Recently, asymmetric sutures have been reported to be effective in the gap formation. However, what has not been studied is the optimal asymmetry or required degree of asymmetry. Therefore, this study was aimed to evaluate the strength in asymmetric core sutures under cyclic load testing. Porcine flexor tendons were used in this study. We sutured porcine flexor tendons using combinations of six-strands Pennington suture and interlocking cross-stitch peripheral suture. This study looked at one symmetrical and five types of asymmetrical six-strands Pennington suture. In reference to the suture standard suture length (10 mm) from the end of the porcine flexor tendon, an asymmetric suture was shifted 1 mm, 2 mm, 3 mm, 4 mm and 5 mm from the reference position, respectively. This experiment was performed under cyclic load testing using an evaluation simulator our research group developed. A 2 N preload was applied to each of the sutured tendons. Tendons were tested with an initial load of 10 N for 500 cycles. If no evidence of failure was noted after the 500 cycles, the force was increased by 5 N for each additional 500 cycles. This procedure was continued until rupture. The sutured tendons were pulled at a constant distraction rate of 300 mm/min. As a result, tendons with 2 mm or more asymmetry had significantly greater the number of cycles to rupture than tendons with symmetry and with 3 mm or more asymmetry had significantly greater the number of cycles to rupture than tendons with asymmetry 1 mm. Tendons with 3 mm or more asymmetry had significantly less gap formation than tendons with symmetry. Furthermore, tendons with asymmetry 3 mm and 4 mm had significantly less gap formation than tendons with asymmetry 1 mm. Asymmetry 3 mm was the highest in both number of cycles to rupture and fatigue strength. Furthermore, it had the smallest value in the gap formation. Therefore, our results support that asymmetry 3 mm produces better beneficial had results compared to the others.
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spelling doaj.art-ef31513f434d48eaac9fff9bdf4cef832022-12-22T03:41:32ZjpnThe Japan Society of Mechanical EngineersNihon Kikai Gakkai ronbunshu2187-97612018-02-018485917-0019117-0019110.1299/transjsme.17-00191transjsmeEvaluation of suture strength of asymmetric six-strands pennington suture in finger flexor tendon sutureRaita MIYAJI0Chika MIYAMOTO1Takeshi SHIMOTO2Atsushi ISHIKAWA3Hidehiko HIGAKI4Go MIAKE5Naoya KOZONO6Takamitsu OKADA7Fukuoka institute of technologyFukuoka institute of technologyFukuoka institute of technologyKyushu Sangyo UniversityKyushu Sangyo UniversityKyushu UniversityKyushu UniversityKyushu UniversityFor the medical treatment of damage or ruptures in the flexor digital tendon, finger flexor tendon suture surgery is utilized. In previous studies, various core suture methods have indicated that important factors affect biomechanical properties, including the number of suture strands. In many suture methods, Fore-strands core suture and Six-strands core suture are used. Recently, asymmetric sutures have been reported to be effective in the gap formation. However, what has not been studied is the optimal asymmetry or required degree of asymmetry. Therefore, this study was aimed to evaluate the strength in asymmetric core sutures under cyclic load testing. Porcine flexor tendons were used in this study. We sutured porcine flexor tendons using combinations of six-strands Pennington suture and interlocking cross-stitch peripheral suture. This study looked at one symmetrical and five types of asymmetrical six-strands Pennington suture. In reference to the suture standard suture length (10 mm) from the end of the porcine flexor tendon, an asymmetric suture was shifted 1 mm, 2 mm, 3 mm, 4 mm and 5 mm from the reference position, respectively. This experiment was performed under cyclic load testing using an evaluation simulator our research group developed. A 2 N preload was applied to each of the sutured tendons. Tendons were tested with an initial load of 10 N for 500 cycles. If no evidence of failure was noted after the 500 cycles, the force was increased by 5 N for each additional 500 cycles. This procedure was continued until rupture. The sutured tendons were pulled at a constant distraction rate of 300 mm/min. As a result, tendons with 2 mm or more asymmetry had significantly greater the number of cycles to rupture than tendons with symmetry and with 3 mm or more asymmetry had significantly greater the number of cycles to rupture than tendons with asymmetry 1 mm. Tendons with 3 mm or more asymmetry had significantly less gap formation than tendons with symmetry. Furthermore, tendons with asymmetry 3 mm and 4 mm had significantly less gap formation than tendons with asymmetry 1 mm. Asymmetry 3 mm was the highest in both number of cycles to rupture and fatigue strength. Furthermore, it had the smallest value in the gap formation. Therefore, our results support that asymmetry 3 mm produces better beneficial had results compared to the others.https://www.jstage.jst.go.jp/article/transjsme/84/859/84_17-00191/_pdf/-char/enflexor tendon repaircore suturenumber of cyclesfatigue strengthcyclic loading
spellingShingle Raita MIYAJI
Chika MIYAMOTO
Takeshi SHIMOTO
Atsushi ISHIKAWA
Hidehiko HIGAKI
Go MIAKE
Naoya KOZONO
Takamitsu OKADA
Evaluation of suture strength of asymmetric six-strands pennington suture in finger flexor tendon suture
Nihon Kikai Gakkai ronbunshu
flexor tendon repair
core suture
number of cycles
fatigue strength
cyclic loading
title Evaluation of suture strength of asymmetric six-strands pennington suture in finger flexor tendon suture
title_full Evaluation of suture strength of asymmetric six-strands pennington suture in finger flexor tendon suture
title_fullStr Evaluation of suture strength of asymmetric six-strands pennington suture in finger flexor tendon suture
title_full_unstemmed Evaluation of suture strength of asymmetric six-strands pennington suture in finger flexor tendon suture
title_short Evaluation of suture strength of asymmetric six-strands pennington suture in finger flexor tendon suture
title_sort evaluation of suture strength of asymmetric six strands pennington suture in finger flexor tendon suture
topic flexor tendon repair
core suture
number of cycles
fatigue strength
cyclic loading
url https://www.jstage.jst.go.jp/article/transjsme/84/859/84_17-00191/_pdf/-char/en
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